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Pain mgt. dr. won't prescribe 2 more pills for my pain relief
meaningfulc1952 posted:
I have been seeing this pain management dr. for about 6 months now. Before going to him, I had a great dr. but he passed away unexpectedly and I have had no way of getting my records from his office. My current pain dr. does not let me have enough of one pain med that I have taken before. I can't seem to make him understand that just 2 more of these pills would greatly improve my chronic pain. Methadone oral is the med I am referring to. Also he has cut my dose of methadone from 12 pills a day to 8/day. If anyone has some ideas about this please let me know.
tonyanmark responded:
I just wish I could find a good dr to help me get any kind of med to stop my pain. Sorry you are having problems.
thr33Ds responded:
I understand what you are going through. It is difficult to find a good doctor. I dropped my pain management doctor because she didn't listen to me and acted like I was wasting her time asking for medication instead of getting more injections. Even with all the therapy, MRI / X-Rays, procedures, etc, when it comes to prescribing pain medication, people get nervous (scared?). I just want to manage the chronic pain so I can function! It get so maddening. See this doctor, get this test done, go see another doctor,and so do I deal with the pain in the meantime? Here is some 5mg norco...I've tried it and it isn't very effective...oh give it a couple weeks to work...arghh.
CTBeth responded:
Hi from Connecticut,

Was your former MD in a group? I would think that his records must be accessible somehow. Did another MD take over the practice?

Are the pills the regular 10 mg? Going from twelve to eight is four pills. Are the doses different or are you thinking that you'd do okay on ten even though you were taking twelve?

Is the issue that your current MD does not want to prescribe that number, or is it that he/she would do so if he/she could review the late MD's records? If it is the latter, perhaps you can get assistance in getting your records.

During the time you were taking twelve pills, did you, perhaps see any other MDs- or even a dentist, who would have a medical record of your dose? When I go to any MD they ask and I tell what meds I am taking. This may be a way to get confirmation of your former dose.

Good luck and I hope you can get the relief you need.

end_of_rope responded:
I am so sorry you lost a dood Dr. they are hard to find for chronic pain. I had to shop around, A LOT, maybe you should make it clear that you know your body best and he/she can treat you as you see fit or you will have to shop around. OR shop around first then tell this Dr. to take a long walk off of a short pier lol, that's what I had to do. I hope you can get what you need. My thoughts are with you.

annette030 responded:
I am pretty sure if you really want your old records you can get them, perhaps not the same day, but in time. The rules usually say the doctor has to maintain your records somewhere for a certain length of time, usually years. Request them in writing, including your full name and birth date.You may be charged a copying fee in some areas.

Methadone comes in 5, and 10 mg. oral tablets, and 40 mg. dissolving tablets that I am aware of. Assuming you are getting 10 mg. tablets, you are on a pretty high daily dose. Your doctor may be uncomfortable prescribing that much. Are you asking for 14 a day, or going up to 10 a day from the 8 he is now prescribing you? Just talk to him and ask him why he is prescribing the drug the way he is. He may have good reasons.

I know I discussed the long term side effects of methadone with my pain management doc (my pcp prescribes it). I had read about cardiac toxicity and altered ECGs. He reassured me that it was only with higher doses than mine that those problems occurred. He suggested one ECG now and then one a year while I was taking methadone. Perhaps your doctor feels the cardiac risk is too high on your present dose, who knows what he thinks? You have to ask him, and really listen to his answers, take notes.

Take care, Annette
CTBeth replied to annette030's response:
Hi Annette,

Just a curious question: Here, in CT, the 40 mg "Methadose" orange dis-solvable methadone tabs are only used in addiction maintenance clinics. We also only have open dose treatment now. In the recent past patients did not know their dose as everyone's daily dose was dissolved in an orange drink.

Is this the case in Oregon? I would say that the east and west coasts are both pretty ahead of other areas of the nation.

When I first took Methadone (for pain), the prescription was filled with the four-scored 40 mg "Methadose". Soon thereafter it became illegal to dispense these for pain management use. I liked them because my dose was 20 mg. It easily broke in half and dissolved in a little Tang. It gave me an excuse to buy and drink Tang which I love. The Methadose did not alter the yummy taste at all.

I am just curious as pain management, as many other things, seem to follow a trend from the coasts on inward. You and I happen to live on opposite sides of the country, but in the high fashioned spots, LOL.

Have a nice weekend. It is freezing here in Connecticut.


mind_situation replied to CTBeth's response:
i am taking 12 10 mg. a day as well and wonder what will happen when the tolerance builds up at that amount.
by the way, freezing on long island as well lol.
TDXSP08 replied to mind_situation's response:
when a tolerance builds to one narcotic you rotate to another for awhile and then go back. thats easy!!!

i have no small step for man, but i have 6 tires for mankind,Watch your Toes!
TDXSP08 responded:
if you cant get your Dr.'s record's showing how much you took most doctors require you to use 1 pharmacy get a printout from them which will show dosage and lenth of time on that dosage.

Think outside the box,these are not hard things to solve in the computer age, it will take the pharmacy's printer longer to print it than it will for your pharmacist to tell it to do so .

Now of course if you are trying to pull a fast one on the New Dr. your "inability" to access records would have to remain.

But This year a Federal database goes online and anyone who prescribes Narcotics can look you up and see every prescription you have filled anywhere for anything so Dr.'s will be able to see scam artists coming from a mile away which we will have to wait and see does it hurt pain patients or does it benefit us?
i have no small step for man, but i have 6 tires for mankind,Watch your Toes!
CTBeth replied to TDXSP08's response:
Wow, ask the pharmacist! That is the perfect solution if the originator of the discussion (I've forgotten who that was) really cannot get records as the MD had died or gotten arrested (there are two people posting and one MD died and another was arrested).

The pharmacy can confirm your previous dosage.
What do you think? Is this something that you can do?

I hope we've given you some ideas on how to live in the solution rather than the problem.


CTBeth replied to TDXSP08's response:
Hey TDX~
Would you be willing to start a new discussion on the proposed federal database?
I'd love to both reply and read others thoughts and feelings.
thanks, and take care,

annette030 replied to CTBeth's response:
Hi, Bet

I just looked it up in my drug handbook, and it said those were the formulas and doses available. Back when I worked as a nurse in a methadone clinic in the 1970s we got our "experimental" methadone and it arrived at our clinic everyday in liquid form, our patients were not told their dose. We mixed it in Kool-Ade. It was also used in a liquid drug cocktail for terminal patients, mixed with cocaine and other drugs. It allegedly treated their pain and allowed them to be awake and alert at the same time. I gave it a few times as a nursing student in 1968-70.

I currently take a 5 mg. tablet of methadone for pain three times a day. It is scored so it can be broken in half, as can the ten mg. tablets. I don't know if the dissolvable tablets are prescribed for pain or not. I can see where they might be just used in clinics that treat addiction as the doses there are so much higher than what are commonly used for pain.

It is cold and wet here in Oregon as usual, lol. Where is Spring????

Hugs, Annnette
annette030 replied to CTBeth's response:
This is true as long as you are established with a single pharmacy. But they still only tell what you have gotten there, not what you got elsewhere.

I would appreciate having a national database for controlled substances as long as it is only used for certain purposes. I would hate for that to be public information.

Hugs, Annette
cweinbl responded:
You are likely requesting a very high dosage of methadone. Even at 10 mg. (the lowest available), 12 tablets is a lot. I would not be surprised that a physician feels uncomfortable prescribing it.

Furthermore, people with chronic pain do much better using a long-acting narcotic (Kadian, Oxycontin, Fentanyl Transdermal, etc.), plus a short-acting narcotic (Hydrocodone, Oxycodone, etc.) for breakthrough pain. That should work much better than using one specific short-acting drug (Methadone) to which you are already likely tolerant.

Tolerance is something we all fight. When you reach the maximum safe dosage and it no longer helps, we must rotate to a chemically different drug for at least 2-3 months. After that, you can return to the original drug at a lower daily dosage.

Please consider the significant advantages offered by a long-acting narcotic. It is always in your bloodstream; thus you avoid the increases in pain associated with every end of dose circumstance.

Consider a drug like Fentanyl Transdermal, which is the most potent pain medication available. As it is absorbed through the dermis, it will bypass the stomach, reducing side effects. And Fentanyl Transdermal lasts for up to 72 hours per dose (patch).

Many of us do much better with a combination of long and short-acting drugs than by taking the highest safe dosage of one drug (Methadone). Try to be open about using different combinations. Please also consider alternate forms of pain management, such as TENS, hypnosis, acupuncture and biofeedback.

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